For many people with rheumatoid arthritis (RA), fun-zapping fatigue is worse than the pain. Yet research shows some easy lifestyle changes can help you enjoy more pep. Here, some real-life strategies from folks on the front line.

1.Real-life fatigue fighter: Gentle exerciseDo you avoid working out because RA is making you tired and achy? While it may seem counterintuitive, doing regular low-intensity aerobic exercise—such as walking and biking—actually ups your energy and reduces pain, reveals a recent analysis of 162 studies in the Journal of Advanced Nursing. For Ashley Boynes, a gentle work-out is immediately reinvigorating. “I walk, do yoga and recently started doing the elliptical. After these activities, my fatigue definitely lifts,” says the Pittsburgh-based freelance writer and blogger for the Arthritis Foundation, Mid-Atlantic Region.

Why it works: “Exercise dials down inflammation and reduces the number of swollen joints—and less pain reduces fatigue,” explains Bevra Hahn, MD, division chief of rheumatology and professor at UCLA.Try it yourself: Start slowly, and let your joints be your guide, Dr. Hahn stresses. “Begin with about 5-10 minutes. If you feel pain for two or three days afterward, it’s too much for your body, so do less. Gradually increase the amount of exercise you do until you can reach 20-30 minutes three times per week or 15-20 minutes five days per week.”

2.Real-life fatigue fighter: Knowing your pain triggersMany people with RA experience trouble sleeping due to pain. Unfortunately, not only does the tossing and turning make you groggy the next day, it worsens RA symptoms by not giving your joints a chance to rest. So what can you do? “I’ve learned which things I do during the day—like going on jet skis—that later can cause pain that makes me lose sleep, so I avoid them,” says Melanie Bonine, a vice president of a public relations firm in Minneapolis, MN.

Why it works: The body’s natural anti-inflammatory cortisol hormones are highest in the morning, so you may not necessarily feel pain while you’re actually doing certain activities. But by day’s end, when these hormones drop sharply, you’ll be more aware of the discomfort, explains Dr. Hahn.

Try it yourself: To pinpoint which activities may be prompting your sleep-disrupting achiness, try keeping a journal tracking everything you do during the day, then make adjustments to limit pain triggers as you become aware of them.

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